Intensive insulin therapy reduces infections in patients on parenteral nutrition- A randomized clinical trial

Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients due to stress and using parenteral nutrition. Uncontrolled hyperglycemia may be associated with increased infection risk. The principal benefit of intensive insulin therapy is a decrease in infection-related complications and mortality. The aim of this study was the assessment of IIT effect on pathogen growth in ICU patients. We conducted a randomized controlled trial study where patients with brain trauma in grade 2 and 3 that received at least 50% of nutritional needs from parenteral nutrition. They randomly assigned to receive IIT or conventional glucose control. Pathogen growth, mortality, survival, APACHE II score, duration of hospital stay was assessed.Of 29 patients randomized, 26 patients completed the study. Survival duration, ventilator dependency and pathogen growth was improved in tight control group but not significant between two groups due to low sample size. In our study, IIT reduced pathogen growth without hypoglycemic episodes in head trauma patients.